Organization
PREFERRED SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J. WILMOTH MD (SOLE OWNER)
(423) 626-4288
Entity
Organization
Contact information
Practice address
1610 TAZEWELL RD, STE 301, TAZEWELL, TN 37879-3600
(423) 626-4288
(423) 626-1101
Mailing address
PO BOX 1349, NEW TAXWELL, TN 37825-1349
(865) 670-6199
(865) 670-6188
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527909
—
TN
Enumeration date
05/01/2012
Last updated
06/29/2012
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